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Endocrinology > Glucocorticoids > Flashcards

Glucocorticoids Flashcards

1
Q

The zona fasciculata secretes _______, primarily ______. The zona reticularis secretes _______, primarily, ______.

A

glucocorticoids
cortisol
androgens
DHEA

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2
Q

List functions of cortisol (4).

A
  1. control metabolism
  2. regulate carbohydrates
  3. repair tissues
  4. some immune function
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3
Q

______ regulates both secretion of glucocorticoids and androgens from the adrenal medulla.

A

ACTH

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4
Q

Where is ACTH produced?

A

anterior pituitary

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5
Q

What is the function of DHEA?

A

converted to testosterone in tissues
main source of estrogen in females

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6
Q

Cortisol and DHEA require ______ for their production.

A

steroid (cholesterol)

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7
Q

List the structures in the synthesis of cortisol in order. (6)

A

cholesterol –> pregnenolone –> progesterone –> 17a-hydroxyprogesterone –> 11-deoxycortisol –> cortisol

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8
Q

Where does cholesterol get converted to pregnenolone in synthesis of cortisol?

A

mitochondria

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9
Q

Where do the following steps in the synthesis of cortisol occur:

pregnenolone –> progesterone –> 17a-hydroxyprogesterone –> 11-deoxycortisol

A

smooth ER

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10
Q

What is the final step in cortisol production? Where does it occur?

A

11-deoxycortisol –> cortisol
location: mitochondria

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11
Q

What hormone is produced in the hypothalamus which causes release of ACTH and therefore cortisol + DHEA secretion?

A

CRH (corticotropic releasing hormone)

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12
Q

What in the hypothalamus produces CRH?

A

paraventricular nucleus

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13
Q

What main metabolic function does cortisol promote?

A

gluconeogenesis

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14
Q

Cortisol (stimulates/inhibits) diuresis and therefore (stimulates/inhibits) ADH release.

A

stimulates
inhibits

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15
Q

In terms of its cellular functions, cortisol is involved in the formation and actions of what structures?

A

catecholamines

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16
Q

Cortisol increases the loss of _______ through urine and feces.

A

calcium

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17
Q

(T/F) Cortisol promotes Na+ secretion and K+ retention.

A

False - opposite

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18
Q

Cortisol promotes (increased/decreased) gastric and pancreatic secretions and (increased/decreased) mucosa proliferation in the GI tract.

A

increased
decreased

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19
Q

(T/F) Cortisol has a strong inotropic effect on the heart’s ability to contract.

A

False - weak

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20
Q

Cortisol causes (vasodilation/vasoconstriction).

A

vasoconstriction

21
Q

Chronic cortisol elevations can cause what 2 musculoskeletal abnormalities?

A
  1. muscle weakness/atrophy
  2. osteoporosis
22
Q

(T/F) Cortisol can decrease the threshold for seizures and cause sleepiness.

A

True

23
Q

Cortisol (strengthens/weakens) the immune system.

A

weakens (blocks TH2 response, increased TH1 + inhibit phagocytic cell migration)

24
Q

DHEA has similar functions as the hormone _________.

A

testosterone

25
Q

DHEA is a substrate for ______ production and development of ________ at puberty.

A

estrogen
secondary sex characteristics

26
Q

List the 5 things treated with glucocorticoid drugs.

A
  1. glucocorticoid deficiency
  2. arthritis
  3. pruritis (itching)
  4. neoplasia
  5. autoimmune disease
27
Q

What are the 3 classes of glucocorticoid drugs?

A

short-acting
intermediate-acting
long-acting

28
Q

What are two specific and common glucocorticoid drugs?

A

prednisolone
dexamethasone

29
Q

What is unique about the structure of prednisolone which increases its potency by 4 times?

A

double-bound at C1-2 position

30
Q

________ at the 16 alpha position of dexamethasone decreases ________ activity.

A

methylation
mineralocorticoid

31
Q

_________ at the 9 alpha position of dexamethasone increases _______ potency and decreases _______ activity.

A

fluorination
corticosteroid
mineralocorticoid

32
Q

What two drugs are in the short-acting glucocorticoid drug class?

A
  1. hydrocortisone
  2. cortisone
33
Q

What 4 drugs are in the intermediate-acting glucocorticoid drug class?

A
  1. prednisone
  2. prednisolone
  3. methylprednisolone
  4. triamcinolone
34
Q

What 3 drugs are in the long-acting glucocorticoid drug class?

A
  1. paramethasone
  2. betamethasone
  3. dexamethasone
35
Q

Term for decreased cortisol production due to problem with the enzyme, 21-hydroxylase.

A

CAH (congenital adrenal hyperplasia)

36
Q

CAH is a disorder where there is decreased production of cortisol due to an issue with ________.

A

21-hydroxylase

37
Q

Individuals with CAH have no 21-hydroxylase function, and therefore (high/low) aldosterone, (high/low) cortisol, and (high/low) ACTH and DHEA.

A

low
low
high

38
Q

CAH patients have a (retention/loss) of ECF volume and (hypotension/hypertension).

A

loss
hypotension

39
Q

What is the main cause of Cushing’s Disease?

A

tumors (pituitary or adrenal)

40
Q

What are the 2 types of Cushing’s Disease? What percentage are patients diagnosed with each?

A
  1. Pituitary Dependent Hyperadrenocorticism (80%)
  2. Adrenal Dependent Hyperadrenocorticism (20%)
41
Q

What is the most common clinical sign of Cushing’s Disease?

A

polydipsia & polyuria

42
Q

Patients with Cushing’s Disease exhibit a(n) (increased/decreased) blood glucose.

A

increased

43
Q

What can become enlarged in Cushing’s Disease?

A

liver/abdomen

44
Q

What are the 2 ways to diagnose Cushing’s Disease?

A
  1. elevated cortisol (blood/urine)
  2. ACTH challenge
45
Q

In an ACTH challenge test, patients have a(n) (increased/decreased) ability to be make cortisol which signifies their diagnosis.

A

increased

46
Q

What drug inhibits adrenocortical steroid biosynthesis and therefore treats Cushing’s Disease?

A

trilostane/vetoryl

47
Q

(T/F) Surgery is a treatment option for Cushing’s Disease.

A

True

48
Q

If a Cushing’s patient is given prolonged glucocorticoid treatment, this can lead to _______ which is iatrogenic or doctor-caused.

A

Addison’s-like Disease (hypoadrenocorticism)

Endocrinology (10 decks)

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